Crackdown may help GPs win premises cash

Plans to tighten PCT regulation of GPs could help practices to extract extra premises funding, the GPC has said.

Primary and Community Services: improving GP services, a document recently sent to all PCTs, said that GPs' obligation to provide 'adequate and suitable premises' was 'a significant commissioning lever'.

If buildings are not brought up to scratch, the document says, it could be grounds for a PCT to terminate a contract.

The document seems to condone the trend by some London PCTs to use poor buildings as an excuse to force small practices into polyclinic-style health centres.

Deputy GPC chairman Dr Richard Vautrey said it would be 'inappropriate' for PCTs to use poor quality buildings to undermine practices that were doing their best with limited capital funding.

But he added that the obligations set out by the document were a double-edged sword. 'This is an important lever that practices themselves can use when approaching PCTs for premises development grants,' he said.

The document also advises PCTs to collect data on premises to target future investment. But it hints at linking such investment to other targets, proposing that trusts use premises incentives 'to drive changes in the pattern of primary medical care provision', and to 'implement new models of provision'.

The DoH document offers PCTs guidance on how to develop and commission a local health strategy, and lays out plans for the tighter regulation of practices.

It argues that the present 'location, size and make-up of GP practices reflect historical business decisions made by GPs and do not adequately meet current needs'.

It calls on PCTs to measure the quality and accessibility of practice services, and transmit details to the public.

DoH plans for GP services
Primary and Community Services: improving GP services offers PCTs advice on measuring the quality of existing practices, and on commissioning new services to fill gaps or increase competition. Its suggested methods include:
  • Developing measures of practice performance such as length and quality of consultations, average patient list size, maximum distances patients travel to a practice and 'value for money';
  • Being 'proactive' about distributing information about the range and quality of practice services;
  • Using 'mystery shopper' techniques to check whether practices are accepting new patients;
  • Abandoning the risk-based performance system currently in use, and instead conducting regular and intensive performance reviews on all providers.

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